If you would like to obtain a copy of your or your family member's medical records, you can:
- Request medical records online (For patients only: Click here)
If you would like to request the release of anatomic pathology materials, you can:
- Print the Authorization for Release of Pathology Slides, Blocks, and/or Reports and mail or fax it to the Pathology Department:
Summit Health
Pathology Department
Bensley Pavilion – Ground Fl.
1 Diamond Hill Rd.
Berkeley Heights, NJ 07922
Or
Fax: 908-464-3076
Request medical records online (click here)
Print and sign the Authorization for the Release of Medical Information form. Please see this example of the medical information form if you need guidance on how to complete the document. Mail or fax the completed form to:
- Faxed to 914-682-6415
- Mailed to: P.O. Box 431 (Attn: Health Information Dept), Port Chester, New York 10573
If you would like to request pathology materials, please contact the Pathology Department directly at:
210 Westchester Avenue, White Plains, NY 10604 (3rd floor behind Eye Care)
Phone: 914-831-6813
Fax: 914-682-6405
Hours of operation are Monday through Friday from 8:00 a.m. to 5:00 p.m.
Previous NJ Urology Patients: MyChart Login
For more information, please email medicalrecordsnju@summithealth.com
Previous Urology Group of Princeton Patients: call 609-924-6487
Frequently Asked Questions
- Yourself (not a spouse)
- A parent if the patient is under the age of 18 years of age
- Court appointed guardian. (Must provide legal documents)
- Power of Attorney if patient is unable to sign (must have documentation)
- Executor/representative of estate for deceased patient with a copy of the short form (death certificate presented)
- A minor may sign their own authorization if they are:
- Emancipated
- Pregnant
- Being treated for venereal disease, sexual assault, alcohol or drug use/abuse
- Age 14 or older and is admitted to a psychiatric facility, children’s crisis intervention service or special psychiatric hospital operated by a state-licensed mental health provider
The form must be completely filled out and signed in order to process the request. Include dates of service, physician, specialty, and type of information. If no dates are specified, the last year of information will be provided.
Both HIPAA and state rules determine the applicable fee for medical records. If there is a fee to process your request, the invoice will be mailed to the address listed on the release form. Payments can be made by credit card or check. Please make checks payable to: Ciox Health.
Yes, you can have a consolidated summary of your health record sent to you instantly via email when you visit the “My Health > Health Records” section of the new Summit Health portal. To access this copy of your medical records, login to your portal from a web browser from a desktop, and click “My Health”. You’ll navigate to “Health Records” and select Outpatient Visit Documentation you are hoping to export – information such as medications list, allergies and immunizations will be included in this data. You can specify a date range, or access this information from your “all time” record.
All requests are worked in the order received. Processing may take up to 10 days from the date a valid authorization is received, however this is not typical.